Provider Demographics
NPI:1699076315
Name:WILLIAMS, ROSEMARY T (LMT)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:T
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 60 BOX 309
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIDGE TOWN
Mailing Address - State:UT
Mailing Address - Zip Code:84645-9806
Mailing Address - Country:US
Mailing Address - Phone:435-660-9714
Mailing Address - Fax:435-623-1906
Practice Address - Street 1:41 S WEST RIDGE ROAD
Practice Address - Street 2:HC 60 309
Practice Address - City:ROCKY RIDGE TOWN
Practice Address - State:UT
Practice Address - Zip Code:84645
Practice Address - Country:US
Practice Address - Phone:435-660-9714
Practice Address - Fax:435-623-1906
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT286902-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist